The importance of health-promoting neighborhoods has long been recognized, and characteristics of local built environments are among the social determinants of health. People with disability are more likely than other population groups to experience geographic mobility and cost restrictions, and to be reliant on ‘opportunity structures’ available locally. We conducted an ecological analysis to explore associations between area-level disability prevalence for people aged 15–64 years and area-level built environment characteristics in Australia’s 21 largest cities. Overall, disability was more prevalent in areas with lower walkability and lower local availability of various neighborhood amenities such as public transport, healthier food options, public open space, physical activity and recreation destinations and health and mental health services. These patterns of lower liveability in areas of higher disability prevalence were observed in major cities but not in regional cities. Our findings suggest that geographically targeted interventions to improve access to health-enhancing neighborhood infrastructure could reduce disability-related inequalities in the social determinants of health.

中文翻译：

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澳大利亚建筑环境特征与残疾患病率之间的地区级关联：生态分析

促进健康的社区的重要性早已得到认识，当地建筑环境的特征是健康的社会决定因素之一。与其他人群相比，残疾人更有可能经历地理流动性和成本限制，并依赖当地现有的“机会结构”。我们进行了一项生态分析，以探讨澳大利亚 21 个最大城市中 15-64 岁人群的地区级残疾患病率与地区级建筑环境特征之间的关联。总体而言，在步行适宜性较低以及当地各种社区设施（例如公共交通、更健康的食物选择、公共开放空间、体育活动和娱乐目的地以及健康和心理健康服务）的可用性较低的地区，残疾更为普遍。这些残疾发生率较高的地区的宜居性较低的模式在主要城市中观察到，但在边远城市中却没有观察到。我们的研究结果表明，针对地理区域采取有针对性的干预措施，以改善获得增强健康的社区基础设施的机会，可以减少健康社会决定因素中与残疾相关的不平等。